R01CA268017

Increasing Physical Activity in Rural Pennsylvanians: The PA Moves Trial - Project Summary / Abstract

A rural/urban disparity in mortality of 8% has been observed for lung, colorectal, prostate, breast, and cervical cancers. Physical inactivity is a modifiable cancer risk factor; physical activity (PA) is associated with risk reductions between 10-20% for breast, colon, and 6 other cancers. Further, rural residents report approximately 24% lower PA compared to urban residents.

Primary care providers are a trusted source of health advice, and they are in an ideal position to assess PA and advise patients regarding becoming and staying physically active. It is estimated that 84.3% of adults had an appointment with a primary health care professional in 2018. Thus, primary care encounters provide an opportunity to promote PA among the majority of rural adults, particularly among those with chronic disease profiles placing them at elevated cancer risk (e.g., overweight, obesity, diabetes).

There is substantial evidence demonstrating the success of primary care providers promoting PA. Advice from providers is most effective in creating sustainable increases in PA when followed by phone or community-based support. The first challenge to implementing this type of approach in rural settings is the need for a methodology to train rural primary care providers to promote PA. We propose to apply the well-validated ECHO model to train providers toward the goal of communicating the health benefits of PA to patients, making clear recommendations, and connecting them to PA resources.

Additional challenges to promoting PA in rural residents are provision of behavioral support and ensuring adequate opportunities for PA. These activities are beyond the scope of practice for primary care providers. We propose to partner with the Harrisburg YMCA to create a 'Moveline' - logistically, the PA equivalent to the highly successful smoking cessation 'Quitline'. Providers will refer patients to the Moveline, who will then counsel and connect patients to PA options available in their communities. Study staff and a Community Advisory Board (CAB), in collaboration with the YMCA, Penn State Extension, and Penn State (PSU) faculty, will work to identify existing PA options and to expand them as well.

While intervening on the built environment is beyond the scope of this application, we acknowledge the importance of the environment on PA by rigorously evaluating its impact on outcomes. We propose a multi-level group randomized trial, including provider advice (patient), coaching and Moveline (patient, social), and educating and promoting community PA opportunities and programs (community). We also evaluate the impact of the built environment on PA outcomes.

We propose this work in collaboration with the Primary Health Network (8 federally qualified health clinics serving rural Pennsylvania), Penn State Health (8 clinics serving rural Pennsylvania), the Harrisburg YMCA, and Penn State Extension to increase PA levels in rural Pennsylvanians, toward the goal of reducing cancer risk. A total of 16 clinics will be randomized to the immediate or delayed treatment condition (2-3 providers nested within each clinic and 20 patients nested within each provider; 800 patients in total).

University Of Pittsburgh - Of The Commonwealth System Of Higher Education

TO IMPROVE SCREENING AND EARLY DETECTION STRATEGIES AND TO DEVELOP ACCURATE DIAGNOSTIC TECHNIQUES AND METHODS FOR PREDICTING THE COURSE OF DISEASE IN CANCER PATIENTS. SCREENING AND EARLY DETECTION RESEARCH INCLUDES DEVELOPMENT OF STRATEGIES TO DECREASE CANCER MORTALITY BY FINDING TUMORS EARLY WHEN THEY ARE MORE AMENABLE TO TREATMENT. DIAGNOSIS RESEARCH FOCUSES ON METHODS TO DETERMINE THE PRESENCE OF A SPECIFIC TYPE OF CANCER, TO PREDICT ITS COURSE AND RESPONSE TO THERAPY, BOTH A PARTICULAR THERAPY OR A CLASS OF AGENTS, AND TO MONITOR THE EFFECT OF THE THERAPY AND THE APPEARANCE OF DISEASE RECURRENCE. THESE METHODS INCLUDE DIAGNOSTIC IMAGING AND DIRECT ANALYSES OF SPECIMENS FROM TUMOR OR OTHER TISSUES. SUPPORT IS ALSO PROVIDED FOR ESTABLISHING AND MAINTAINING RESOURCES OF HUMAN TISSUE TO FACILITATE RESEARCH. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.310 - Trans-NIH Research Support

National Cancer Institute (NCI) [HHS - NIH]

National Institute of Allergy and Infectious Diseases (NIAID) [HHS - NIH]

Pittsburgh, Pennsylvania 152221808 United States

Single Zip Code

Administrative Supplements to Existing NIH Grants and Cooperative Agreements (Parent Admin Supp Clinical Trial Optional) (PA-20-272)

Amendment Since initial award the total obligations have increased 329% from $921,979 to $3,956,980.